HESI OB/Maternity Practice Exam
1. Twenty minutes after a continuous epidural anesthetic is administered, a
laboring client's blood pressure drops from 120/80 to 90/60. What action will
the nurse take?
A. Notify the healthcare provider or anesthesiologist immediately
B. Continue to assess the blood pressure q5 minutes
C. Place the woman in a lateral position
D. Turn off the continuous epidural: C. Place the woman in a lateral position
These symptoms are suggestive of hypotension which is a side effect of epidural
anesthesia. Raising the foot of the bed will increase venous return and provide
blood to the vital areas. Increasing the IV fluid rate using a balanced non-dextrose
solution and ensuring that the client is in a lateral position are also appropriate
interventions, and then checking the patients blood pressure.
2. A newborn infant is brought to the nursery from the birthing suite. The
nurse notices that the infant is breathing satisfactorily but appears dusky.
What action should the nurse take first?
A. Notify the pediatrician immediately
B. Suction the infant's nares, then the oral cavity
C. Check the infant's oxygen saturation rate
D. Position the infant on the right side: C. Check the infant's oxygen saturation
rate
When possible, the nurse should first obtain measurable objective data; an oxygen
saturation rate provides such information.
FYI. The pediatrician should be notified if the oxygen saturation rate is below 90%
3. The nurse is teaching breastfeeding to prospective parents in a childbirth
education class. Which instruction should the nurse include as content in the
class?
A. Begin as soon as your baby is born to establish a four-hour feeding
schedule
B. Resting helps with milk production. Ask that your baby be fed at night
in the nursery
, HESI OB/Maternity Practice Exam
C. Feed your baby every 2 to 3 hours or on demand, whichever comes
firstD. Do not allow your baby to nurse any longer than the prescribed
number of minutes: C. Feed your baby every 2 to 3 hours or on demand,
whichever comes first
Breastfeeding infants should be kept in the room with the mother and fed every 2 to
3 hours or on demand--whichever comes first.
4. A client is admitted with the diagnosis of total placenta previa. Which
finding is most important for the nurse to report to the healthcare provider
immediately?
A. Heart rate of 100 beats/minute
B. Variable fetal heart rate
C. Onset of uterine contractions
D. Burning on urination: C. Onset of uterine contractions
Total (complete) placenta previa involves the placenta covering the entire cervical
os (opening). The onset of uterine contractions places the client at risk for dilation
and placental separation, which causes painless hemorrhaging.
5. A 42-week gestational client is receiving an intravenous infusion of
oxytocin (Pitocin) to augment early labor. the nurse should discontinue the
oxytocin infusion for which pattern of contractions?
A. Transition labor with contractions every 2 minutes, lasting 90 seconds
each
B. Early labor with contractions every 5 minutes, lasting 40 seconds each
C. Active labor with contractions every 31 minutes, lasting 60 seconds
eachD. Active labor with contractions every 3 to 3 minutes, lasting 70 to
80 seconds each: A. Transition labor with contractions every 2 minutes, lasting
90 seconds each
When oxytocin causes uterine hyperstimulation as evidence by inadequate resting
time between contractions, the oxytocin infusion should be discontinued because
placental perfusion is impeded
6. Twenty-four hours after admission to the newborn nursery, a full-term male
infant develops localized edema on the right side of his head. The nurse
knows that, in the newborn, an accumulation of blood between the
, HESI OB/Maternity Practice Exam
periosteum and skull which does not cross the suture line is a newborn
variation known as A. a cephalhematoma, caused by forceps trauma and may
last up to 8 weeks B. a subarachnoid hematoma, which requires immediate
drainage to prevent further complications
C. molding, caused by pressure during labor and will disappear withing 2
to 3 days
D. a subdural hematoma which can result in lifelong damage: A. a
cephalhematoma, caused by forceps trauma and may last up to 8 weeks
Cephalhematoma, a slight abnormal variation of the newborn, usually arises within
the first 24 hours after delivery. Trauma from delivery causes capillary bleeding
between the periosteum and the skull.
7. The nurse is assessing a 3-day old infant with a cephalohematoma in the
newborn nursery. Which assessment finding should the nurse report to the
healthcare provider?
A. Yellowish tinge to the skin
B. Babinski reflex present bilaterally
C. Pink papular rash on the face
D. Moro reflex noted after a loud noise: A. Yellowish tinge to the skin
Cephalohematomas are characterized by bleeding between the bone and its
covering, the periosteum. Due to the breakdown of the red blood cells within a
hematoma, the infant is at a greater risk for jaundice, so a yellowish tinge to the skin
should be reported.
8. After each feeding, a 3-day-old newborn is spitting up large amounts of
Enfamil Newborn Formula, a nonfat cow's milk formula. The pediatric
healthcare provider changes the neonate's formula to Simialc Soy Isomil
formula, a soy protein isolate based infant formula. What information should
the nurse provide to the mother about the newly prescribed formula?
A. The new formula is a coconut milk formula used with babies with
impaired fat absorption
B. enfamil Formula is a demineralized whey formula that is needed with
diarrhea
, HESI OB/Maternity Practice Exam
C. The new formula is a casein protein source that is low in
phenylalanineD. Similac Soy Isomil Formula is a soy-based formula that
contains sucrose: D. Similac Soy Isomil Formula is a soy-based formula that
contains sucrose
The nurse should explain that the newborn's feeding intolerance may be related to
the lactose found in cow's milk formula and is being replaced with the soy-based
formula that contains sucrose, which is well-tolerated in infants with milk allergies
and lactose intolerance.
9. A full term infant is transferred to the nursery from labor and delivery.
Which information is most important for the nurse to receive when planning
immediate care for the newborn?
A. Length of labor and method of delivery
B. Infant's condition at birth and treatment received
C. Feeding method chosen by the parents
D. History of drugs given to the mother during labor: B. Infant's condition at
birth and treatment received
Immediate care is most dependent on the infant's current status (i.e., Apgar scores
at 1 and 5 minutes) and any treatment or resuscitation that was indicated.
10. Client teaching is an important part of the maternity nurse's role. Which
factor has the greatest influence on successful teaching of the gravid
client?
A. The client's readiness to learn
B. The client's educational background
C. The order in which the information is presented
D. The extent to which the pregnancy was planned: A. The client's readiness to
learn
When teaching any client, readiness to learn is the most important criterion. For
example, the client with severe morning sickness in the first trimester may not be
"ready to learn" about labor and delivery, but is probably very "ready to learn" about
ways to relieve morning sickness.
1. Twenty minutes after a continuous epidural anesthetic is administered, a
laboring client's blood pressure drops from 120/80 to 90/60. What action will
the nurse take?
A. Notify the healthcare provider or anesthesiologist immediately
B. Continue to assess the blood pressure q5 minutes
C. Place the woman in a lateral position
D. Turn off the continuous epidural: C. Place the woman in a lateral position
These symptoms are suggestive of hypotension which is a side effect of epidural
anesthesia. Raising the foot of the bed will increase venous return and provide
blood to the vital areas. Increasing the IV fluid rate using a balanced non-dextrose
solution and ensuring that the client is in a lateral position are also appropriate
interventions, and then checking the patients blood pressure.
2. A newborn infant is brought to the nursery from the birthing suite. The
nurse notices that the infant is breathing satisfactorily but appears dusky.
What action should the nurse take first?
A. Notify the pediatrician immediately
B. Suction the infant's nares, then the oral cavity
C. Check the infant's oxygen saturation rate
D. Position the infant on the right side: C. Check the infant's oxygen saturation
rate
When possible, the nurse should first obtain measurable objective data; an oxygen
saturation rate provides such information.
FYI. The pediatrician should be notified if the oxygen saturation rate is below 90%
3. The nurse is teaching breastfeeding to prospective parents in a childbirth
education class. Which instruction should the nurse include as content in the
class?
A. Begin as soon as your baby is born to establish a four-hour feeding
schedule
B. Resting helps with milk production. Ask that your baby be fed at night
in the nursery
, HESI OB/Maternity Practice Exam
C. Feed your baby every 2 to 3 hours or on demand, whichever comes
firstD. Do not allow your baby to nurse any longer than the prescribed
number of minutes: C. Feed your baby every 2 to 3 hours or on demand,
whichever comes first
Breastfeeding infants should be kept in the room with the mother and fed every 2 to
3 hours or on demand--whichever comes first.
4. A client is admitted with the diagnosis of total placenta previa. Which
finding is most important for the nurse to report to the healthcare provider
immediately?
A. Heart rate of 100 beats/minute
B. Variable fetal heart rate
C. Onset of uterine contractions
D. Burning on urination: C. Onset of uterine contractions
Total (complete) placenta previa involves the placenta covering the entire cervical
os (opening). The onset of uterine contractions places the client at risk for dilation
and placental separation, which causes painless hemorrhaging.
5. A 42-week gestational client is receiving an intravenous infusion of
oxytocin (Pitocin) to augment early labor. the nurse should discontinue the
oxytocin infusion for which pattern of contractions?
A. Transition labor with contractions every 2 minutes, lasting 90 seconds
each
B. Early labor with contractions every 5 minutes, lasting 40 seconds each
C. Active labor with contractions every 31 minutes, lasting 60 seconds
eachD. Active labor with contractions every 3 to 3 minutes, lasting 70 to
80 seconds each: A. Transition labor with contractions every 2 minutes, lasting
90 seconds each
When oxytocin causes uterine hyperstimulation as evidence by inadequate resting
time between contractions, the oxytocin infusion should be discontinued because
placental perfusion is impeded
6. Twenty-four hours after admission to the newborn nursery, a full-term male
infant develops localized edema on the right side of his head. The nurse
knows that, in the newborn, an accumulation of blood between the
, HESI OB/Maternity Practice Exam
periosteum and skull which does not cross the suture line is a newborn
variation known as A. a cephalhematoma, caused by forceps trauma and may
last up to 8 weeks B. a subarachnoid hematoma, which requires immediate
drainage to prevent further complications
C. molding, caused by pressure during labor and will disappear withing 2
to 3 days
D. a subdural hematoma which can result in lifelong damage: A. a
cephalhematoma, caused by forceps trauma and may last up to 8 weeks
Cephalhematoma, a slight abnormal variation of the newborn, usually arises within
the first 24 hours after delivery. Trauma from delivery causes capillary bleeding
between the periosteum and the skull.
7. The nurse is assessing a 3-day old infant with a cephalohematoma in the
newborn nursery. Which assessment finding should the nurse report to the
healthcare provider?
A. Yellowish tinge to the skin
B. Babinski reflex present bilaterally
C. Pink papular rash on the face
D. Moro reflex noted after a loud noise: A. Yellowish tinge to the skin
Cephalohematomas are characterized by bleeding between the bone and its
covering, the periosteum. Due to the breakdown of the red blood cells within a
hematoma, the infant is at a greater risk for jaundice, so a yellowish tinge to the skin
should be reported.
8. After each feeding, a 3-day-old newborn is spitting up large amounts of
Enfamil Newborn Formula, a nonfat cow's milk formula. The pediatric
healthcare provider changes the neonate's formula to Simialc Soy Isomil
formula, a soy protein isolate based infant formula. What information should
the nurse provide to the mother about the newly prescribed formula?
A. The new formula is a coconut milk formula used with babies with
impaired fat absorption
B. enfamil Formula is a demineralized whey formula that is needed with
diarrhea
, HESI OB/Maternity Practice Exam
C. The new formula is a casein protein source that is low in
phenylalanineD. Similac Soy Isomil Formula is a soy-based formula that
contains sucrose: D. Similac Soy Isomil Formula is a soy-based formula that
contains sucrose
The nurse should explain that the newborn's feeding intolerance may be related to
the lactose found in cow's milk formula and is being replaced with the soy-based
formula that contains sucrose, which is well-tolerated in infants with milk allergies
and lactose intolerance.
9. A full term infant is transferred to the nursery from labor and delivery.
Which information is most important for the nurse to receive when planning
immediate care for the newborn?
A. Length of labor and method of delivery
B. Infant's condition at birth and treatment received
C. Feeding method chosen by the parents
D. History of drugs given to the mother during labor: B. Infant's condition at
birth and treatment received
Immediate care is most dependent on the infant's current status (i.e., Apgar scores
at 1 and 5 minutes) and any treatment or resuscitation that was indicated.
10. Client teaching is an important part of the maternity nurse's role. Which
factor has the greatest influence on successful teaching of the gravid
client?
A. The client's readiness to learn
B. The client's educational background
C. The order in which the information is presented
D. The extent to which the pregnancy was planned: A. The client's readiness to
learn
When teaching any client, readiness to learn is the most important criterion. For
example, the client with severe morning sickness in the first trimester may not be
"ready to learn" about labor and delivery, but is probably very "ready to learn" about
ways to relieve morning sickness.
